The Role of Poly Vinyl Pyrrolidone Iodine (PVP-I) in Preventing Cross-Infection during Dental Procedures: A Systematic Review in the COVID-19 Context

Aim: As the dental community navigates the challenges posed by the coronavirus disease 2019 (COVID-19) pandemic, mitigating the risk of viral cross-transmission among dentists and dental clinic operators remains paramount. Polyvinyl pyrrolidone iodine (PVP-I) has emerged as a promising agent in reducing the chance of cross-transmission, primarily through its broad-spectrum antiseptic properties and ability to kill viruses rapidly. This study aimed to explore the role of PVP-I in preventing cross-infection of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) and assess its effectiveness as a prophylaxis before dental treatment. Materials and Methods: A comprehensive search of multiple databases, including Science Direct, PubMed, Sage Journal, Cochrane, and Wiley Online Library, was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The study selection process utilized the Patient, Intervention, Comparison, Outcome, and Study Design framework (P: SARS-CoV-2 positive individuals, I: PVP-I mouthwash, C: various PVP-I concentrations, O: virucidal effect, S: randomized-controlled trials and clinical trials). Titles and abstracts were screened for relevance, and full-text articles were assessed for eligibility based on predefined inclusion and exclusion criteria. The risk of bias was assessed using the Cochrane Risk of Bias Tool version 2 for randomized controlled trials and Toxicological Data Reliability Assessment Tool for in vitro studies. A total of 11 articles (seven in vitro and four in vivo) were included in the systematic review. Results: Our findings suggest that PVP-I exhibits superior antiseptic properties compared to other agents, with gargling using PVP-I solutions of 0.2 and 0.5 demonstrating significant efficacy in reducing viral load in saliva. Notably, PVP-I showed rapid virucidal action, effectively reducing SARS-CoV-2 viral particles and potentially lowering the risk of cross-infection during dental procedures. However, despite these promising results in viral reduction, the evidence remains insufficient to definitively recommend PVP-I as a routine clinical prophylaxis for preventing cross-infection in dental care settings during the COVID-19 pandemic. Further large-scale clinical trials are necessary to establish its widespread use. Conclusion: This systematic review highlights the potential of PVP-I as a critical antiseptic in dental settings to mitigate the risk of SARS-CoV-2 transmission. The rapid and significant reduction in viral load suggests that PVP-I could play a pivotal role in infection control protocols. Nonetheless, further robust clinical trials are essential to confirm its efficacy and guide its adoption in routine dental care practices. © Journal of International Society of Preventive and Community Dentistry.